| RPT |
|Pain Self-Efficacy Questionnaire-2 (PSEQ-2)
| Gender: <.Patient_Gender.>
|
| PSEQ-2 Total Score = <*Answer_7771*>
|
| Scores can range from 0-12 with higher scores indicating greater
| self-efficiency for managing pain.
|
|
|Questions and Answers:
|
|
| 1. I can do some form of work, despite the pain ('work' includes
| housework, paid and unpaid work).
| <*Answer_9174*>
| 2. I can live a normal lifestyle, despite the pain.
| <*Answer_9175*>
|
|Information contained in this note is based on a self-report assessment
|and is not sufficient to use alone for diagnostic purposes. Assessment
|results should be verified for accuracy and used in conjunction with
|other diagnostic activities.
| Date Given: <.Date_Given.>
| Clinician: <.Staff_Ordered_By.>
| Location: <.Location.>
|
| Veteran: <.Patient_Name_Last_First.>
| SSN: <.Patient_SSN.>
| DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)
|
